Immune globulin use at a multihospital medical center

Gajewski, Lidia K.; Bailey, E.; Brown, Patricia D.; Chandrasekar, Pranatharthi H.

doi:10.1093/ajhp/51.6.801

Cited by 3 publications

(3 citation statements)

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“…FDA‐licensed indications have been reported for an estimated 35 to 60% of the consumption of IVIG . In studies that supply IVIG according to local guidelines, labeled indications accounted for 31 to 75% …”

Section: Discussionmentioning

confidence: 99%

“…20 FDA-licensed indications have been reported for an estimated 35 to 60% of the consumption of IVIG. 23,[38][39][40] In studies that supply IVIG according to local guidelines, labeled indications accounted for 31 to 75%. 21,[23][24][25]41 The high incidence of off-label IVIG utilization can be explained by the rarity of these patient conditions.…”

Section: Labeled Versus Off-label Indications For Prescription Of Ivigmentioning

confidence: 99%

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Clinical indications for intravenous immunoglobulin utilization in a tertiary medical center: a 9‐year retrospective study

2017

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Section: Discussionmentioning

confidence: 99%

Section: Labeled Versus Off-label Indications For Prescription Of Ivigmentioning

confidence: 99%

Clinical indications for intravenous immunoglobulin utilization in a tertiary medical center: a 9‐year retrospective study

2017

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“…However, there are still substantial differences in the amounts of Ig prescribed by individual practitioners, and it is important to understand the utilization of Ig in the treatment of PIDD in the United States. Most previous publications on the use of Ig have focused on global Ig use in hospital settings [1, 10–12]. As 45.1 % of all subjects with PIDD are likely to receive Ig treatment [13], and in most cases in the home, we examined the demographics, products, and dosing of Ig used in the home care setting for a large cohort of subjects with PIDD in the United States.…”

Section: Introductionmentioning

confidence: 99%

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

2012

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Purpose Utilization reports on immunoglobulin (Ig) use for immunodeficiency in the United States (U.S.) have focused on prescribing practices in hospitals. There have been no large-scale reports on Ig use for immune deficiency in the home. We investigated the use of Ig in 3,187 subjects diagnosed with primary immunodeficiency. Methods Cross-sectional data on 4,580 subjects in the U.S. receiving Ig in 2011 was obtained from a major home care provider. Demographics, route, dose, and frequency of Ig use by subjects with ICD-9 coded primary immunodeficiencies were analyzed. Results Of 4,580 subjects, 3,187 had ICD-9 codes suggesting primary immunodeficiencies; 1,939 (60.8 %) were females and 1,248 (39.2 %) were males, with age ranging from 0 to 95 years. The predominant diagnoses were: common variable immunodeficiency (279.06; n =1,764; 55.3 %), hypogammaglobulinemia (279.00; n=635; 19.9 %), unspecified immunity deficiency (279.3; n=286; 9 %), other selective Ig deficiencies (279.03; n=171; 5.4 %), and agammaglobulinemia (279.04; n=127; 4 %). 54 % of subjects received Ig by the subcutaneous (SC) route, and 46 % by intravenous (IV) route, with more SC use by older subjects. The mean dose prescribed was 483 mg/kg/month, but less Ig was ordered for subjects on SCIg (409 mg/kg/month), as compared to subjects on IVIg (568 mg/kg/month). A highly significant inverse correlation between increasing age and dosage of Ig ordered was found (P=<.0001). Conclusion Analysis of home care use of Ig in primary immune deficiency revealed that the SC route was prescribed more than the IV route, especially for older patients. By either method of administration, less immunoglobulin was prescribed for older subjects.

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A utilisation review of intravenous immunoglobulin in a tertiary care hospital in United Arab Emirates

Dawoud¹,

Tatari²,

Gebran³

2012

Eur J Hosp Pharm

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Objectives To evaluate the utilisation of intravenous immunoglobulin (IVIG) at Tawam Hospital, a tertiary care teaching hospital, over a 1-year period. Methods Patients who received IVIG from March 2010 to April 2011 at Tawam Hospital were identified retrospectively using the hospital computer system. Their charts were subsequently reviewed and data were collected on patients' demographics, indication, dose regimen, adverse drug reactions and physician specialty. Indications were placed into three main categories: US Food and Drug Administration (FDA) labelled; off-label indications with evidence favouring IVIG efficacy; and off-label indications with lack of evidence for efficacy. Results A total of 134 patients (74 paediatric and 60 adult) were identified. In 39%of paediatric versus 46% of adult patients, IVIG was dispensed for appropriate indications (US FDA labelled and off-label with support for use). However, 61%of paediatric patients and 54% of adult patients received IVIG for inappropriate indications (off-label use without support). The estimated annual cost of IVIG is US$1.25 million, of which US$0.7 million was considered as inappropriate use. Conclusions A significant amount of IVIG was prescribed for inappropriate indications, resulting in a large financial burden on the institution.

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Immune globulin use at a multihospital medical center

Cited by 3 publications

References 0 publications

Clinical indications for intravenous immunoglobulin utilization in a tertiary medical center: a 9‐year retrospective study

Clinical indications for intravenous immunoglobulin utilization in a tertiary medical center: a 9‐year retrospective study

Home Care Use of Intravenous and Subcutaneous Immunoglobulin for Primary Immunodeficiency in the United States

A utilisation review of intravenous immunoglobulin in a tertiary care hospital in United Arab Emirates

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